Rinaldi L, Lisi F, Floccari A, Lisi R, Pepe G, Fishel S
Biogenesi, Servizio di Fisopatologia della Riproduzione, Casa di Cura Villa Europa, 27 Via Eufrate, 00144 Roma, Italy.
Hum Reprod. 1996 Jul;11(7):1538-41. doi: 10.1093/oxfordjournals.humrep.a019434.
An ultrasonographic evaluation of the endometrium was performed in 158 patients undergoing ovarian stimulation for an in-vitro assisted reproduction programme. Endometrial thickness was evaluated in 109 patients undergoing in-vitro fertilization (IVF) for female indications and in 49 patients undergoing intracytoplasmic sperm injection (ICSI) for male indications. The maximal endometrial thickness was measured on the day of human chorionic gonadotrophin (HCG) administration by longitudinal scanning of the uterus on the frozen image using electronic callipers placed at the junction of the endometrium-myometrium interface at the level of the fundus. Cases in which the endometrial thickness was >/=10 mm were included in group A; cases in which the endometrial thickness was <10 mm were assigned to group B. The age of the patients, serum 17-beta oestradiol concentrations on the day of HCG administration, the length of follicular stimulation, the number of follicles, 17-beta oestradiol concentrations per follicle on the day of HCG and the number of embryos transferred were analysed in each case. When comparing endometrial thickness and results in IVF and ICSI patients, an endometrium <10 mm predominated in IVF patients (27.5%) compared with those undergoing ICSI (16.7%) (P = 0.05); conversely an endometrium >=10 mm was more frequent in ICSI than in IVF patients. The incidence of pregnancy was higher in IVF group A patients (32/79; 41%) than in IVF group B patients (5/30; 17%) (P = 0.03), whereas no significant difference was found between ICSI group A (13/42; 31%) and ICSI group B (3/7; 43%) patients. Thus, a higher percentage of IVF patients had thin endometrium when compared with ICSI patients; thin endometrium was a prognostic indicator of pregnancy only in the case of a female indication for infertility (IVF). A thin endometrium in cases of female infertility may reflect a previous or present uterine pathology, whereas in indications of male infertility (i.e. cases using ICSI), in the absence of any associated uterine pathology, the presence of a thin endometrium is not predictive.
对158名接受卵巢刺激以进行体外辅助生殖计划的患者进行了子宫内膜的超声评估。对109名因女性适应症接受体外受精（IVF）的患者和49名因男性适应症接受卵胞浆内单精子注射（ICSI）的患者的子宫内膜厚度进行了评估。在注射人绒毛膜促性腺激素（HCG）当天，通过在子宫底水平的子宫内膜 - 肌层界面交界处放置电子卡尺，在冻结图像上对子宫进行纵向扫描来测量最大子宫内膜厚度。子宫内膜厚度≥10mm的病例纳入A组；子宫内膜厚度<10mm的病例分配到B组。分析了每个病例中患者的年龄、注射HCG当天的血清17-β雌二醇浓度、卵泡刺激的时长、卵泡数量、注射HCG当天每个卵泡的17-β雌二醇浓度以及移植胚胎的数量。比较IVF和ICSI患者的子宫内膜厚度及结果时，IVF患者中子宫内膜<10mm的比例（27.5%）高于接受ICSI的患者（16.7%）（P = 0.05）；相反，ICSI患者中子宫内膜≥10mm的情况比IVF患者更常见。IVF组A患者的妊娠率（32/79；41%）高于IVF组B患者（5/30；17%）（P = 0.03），而ICSI组A（13/42；31%）和ICSI组B（3/7；43%）患者之间未发现显著差异。因此，与ICSI患者相比，IVF患者中子宫内膜薄的比例更高；仅在女性不孕症适应症（IVF）的情况下，薄子宫内膜是妊娠的预后指标。女性不孕症病例中的薄子宫内膜可能反映先前或当前的子宫病变，而在男性不孕症适应症（即使用ICSI的病例）中，在没有任何相关子宫病变的情况下，薄子宫内膜的存在并无预测价值。
